Holdeman v. Devine

474 F.3d 770, 39 Employee Benefits Cas. (BNA) 2342, 2007 U.S. App. LEXIS 928, 2007 WL 102980
CourtCourt of Appeals for the Tenth Circuit
DecidedJanuary 17, 2007
Docket05-4302
StatusPublished
Cited by12 cases

This text of 474 F.3d 770 (Holdeman v. Devine) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Holdeman v. Devine, 474 F.3d 770, 39 Employee Benefits Cas. (BNA) 2342, 2007 U.S. App. LEXIS 928, 2007 WL 102980 (10th Cir. 2007).

Opinion

BRISCOE, Circuit Judge.

Plaintiffs, , the representatives of a class of employees and their dependents who were participants in a medical benefit plan sponsored and funded by their employer and governed by the Employee Retirement Income Security Act of 1974 (ERISA), were left- with significant, outstanding medical bills when their employer failed to properly fund the plan and then filed for bankruptcy. Plaintiffs sued defendant Michael Devine, who simultaneously served as an officer of the employer and as a plan fiduciary, alleging he breached his fiduciary duties to the plan in various ways. Following a bench trial, the district court entered judgment in favor of Devine. Plaintiffs now appeal. We exercise jurisdiction pursuant to 28 U.S.C. § 1291, affirm in part, reverse in part, and remand for further proceedings.

*772 I.

A Factual background

1)The Plaintiffs and the Plan

Plaintiff Terrence D. Holdeman is the class representative of a group of employees, and dependents of those employees, of the State Line Hotel and Silver Smith Casino in Wendover, Nevada. . The hotel and casino were owned and operated by State Line Hotel, Inc., and its related entities (State Line). 1

For many years, State Line had maintained a self-funded employee benefit plan. The funding for this plan came from two sources: contributions made by the covered employees and funds allocated to the plan by State Line. Claims for benefits were paid in the order in which they were received. Claims above a certain dollar amount were covered, to the extent they exceeded the relevant dollar amount, by reinsurance.

Holdeman and the other class members were covered under the State Line & Silver Smith Casino Resorts Employee Benefits Plan (the Plan), which became effective on May 1, 1999. The Plan, like State Line’s previous plans, was self-funded. The Summary Plan Description (SPD), as originally drafted, “was inconsistent in its identification of who the plan administrator was.” App. at 1370. In particular, the SPD first identified State Line & Silver Smith Casino Resorts as the plan administrator, but later named Michael Devine as the plan administrator and fiduciary of the plan. The third-party administrator for the Plan was identified as MGIS companies. On May 1, 2001, the Plan was amended. The accompanying SPD identified only State Line Hotel, Inc. and Affiliated Entities as the plan administrator and fiduciary. The amended Plan terminated in December of 2001.

2) Defendant Michael Devine

Defendant Michael Devine is the son of Billie Ann Smith Devine, one of the owners of State Line. In late 1997 or early 1998, Devine, who at the time was practicing law in Salt Lake City, was asked by professional advisors of State Line to consider helping out the family business. Devine agreed to do so, and began working as State Line’s Executive Vice President and General Counsel in January 1998. Devine later became President of State Line (August 1999), and ultimately President and CEO of State Line (April 2000).

At the time Devine joined State Line in early 1998, State Line was facing financial difficulties resulting from a recent, major expansion project. One of Devine’s primary duties thus became working with State Line’s lenders to resolve legal issues. For example, Devine was involved in negotiating a forbearance agreement with State Line’s lenders in 1998 that allowed State Line to continue to operate and avoid foreclosure. Under the forbearance agreement, State Line had to report monthly to the lenders and was subject to surprise inspections by the lenders’ auditors, attorneys, and accountants.

3) Devine’s involvement with the Plan

When Devine joined State Line in January 1998, he was aware “there were some funding problems with the [P]lan,” but “was not integrally involved in dealing with those problems at that time.” App. at 1373. “At some point after joining” State Line, however, Devine became in *773 volved in making changes to the Plan. Id. For example, he and his managerial staff considered changing to a fully-insured group plan, but concluded that option was too expensive for State Line. Devine and his managerial staff then requested competitive proposals for a new third-party administrator for the Plan, and ultimately chose MGIS as the third-party administrator. 2 Concomitant with selecting MGIS, Devine and State Line implemented a new, self-funded medical benefits plan on May 1,1999. It is undisputed that, as of May 1, 1999, Devine was considered a fiduciary of the Plan.

When the Plan was first implemented, MGIS “processed all claims and issued all payment checks to providers.” Id. at 1378. At some point in 2000, “this process changed, and instead of issuing the checks directly to providers, MGIS forwarded the payment checks to State Line for State Line to keep until adequate funding was available, at which point State Line itself would release the checks.” Id. State Line generally tried to pay the claims on a first-in, first-out basis.

Between May 1, 1999, and April 2000, when he became CEO of State Line, De-vine “was vaguely aware of’ Plan funding problems and “had been told by one employee ... of a delay in payment.” Id. at 1375. However, he “did not regularly meet [during this time period] to discuss” these issues. Id. Nor did he advise State Line’s CEO at that time, Mac Potter, “that the [P]lan had to be funded before any commercial creditors .were paid....” Id. According to Devine, “he believed that [State Line] had to pay both and that these responsibilities were competing.” Id.

In late January 2000, State Line’s financial personnel determined that the Plan’s unpaid medical claims were $300,000 greater than previously believed. When all unpaid medical claims were tallied, they totaled approximately $1.2 million. This determination, in part, led to Devine’s appointment as CEO of State Line in April 2000.

After becoming CEO, Devine “began meeting with all of the executive directors,” and “[u]nderfunding of the [P]lan became a regular topic of conversation at these meetings, as well as at the meetings of’ State Line’s Board of Directors, “because the arrearages were [negatively] impacting] ... the business and the employees.” Id. at 1376. Under Devine’s direction, State Line “began focusing on growing the ‘top line’ so that there would be income to pay all expenses — including medical expenses.” Id. at 1377. As CEO of State Line, Devine generally had no involvement in “deciding the right balance in terms of who would get paid.” Id. at 1377. Although Devine would “[v]ery occasionally” direct that a particular medical claim be paid in order to prevent the medical provider from cutting off service to State Line employees or refusing to give further discounts, id.,

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Bluebook (online)
474 F.3d 770, 39 Employee Benefits Cas. (BNA) 2342, 2007 U.S. App. LEXIS 928, 2007 WL 102980, Counsel Stack Legal Research, https://law.counselstack.com/opinion/holdeman-v-devine-ca10-2007.